This position is primarily responsible for performing billing of members and reimbursement services of claims and duties to hospitals utilized by CHP. Other job duties will be to perform billing, collections and reimbursement services in a prompt and efficient manner. Also, provides thorough, courteous and professional assistance to members, physician offices, insurance companies and other clients on an as needed basis while maintaining strictest confidence. The position will document, forward, resolve incoming mail and correspondence.
Responds to member and insurance company complaints, correspondence, inquiries and requests for information by analyzing member billing errors and claim checks investigations and makes appropriate corrections.
Ensures quality standards are met and proper documentation regarding member accounting records.
Reviews and resolves bills, payments and claims that are suspended daily in electronic files in accordance with procedure.
Ensures all correspondence, rejected claims and returned mail is worked within 48 hours of receipt (allowing for weekends and holidays). Ensures business service requests are worked and documented within 24 hours of receipt.
Reviews all payments received to verify accuracy by evaluating the bill.
Provides continuous updates and information to management regarding ongoing errors, payer related issues and other controllable quality assessment related activities affecting reimbursement and payment methodology.
Responsible for working all payments received, provide proper documentation of application, make necessary corrections within two business days of receipt.
Works collaboratively with team members to assist in keeping workload evenly distributed.
Ensures quality standards are met in clerical services performed in accordance with Integrity and Compliance guidelines.
Must have minimum of 6 months experience in any of the following: Medicare, Medicaid and/or Commercial Insurance billing, collections, customer service, payment and reimbursement verification and/or refunds.
General hospital A/R accounts knowledge is required. College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience.
B. Education and Training:
HS Diploma or equivalency required
Post HS education preferred
Must have good verbal and written communication skills in order to present and explain information to internal and external customers.
Ability to write letters.
Must have practical experience with Word, Excel, Adobe applications.
Must have ability to make independent decisions that are generally guided by established procedures.
Must have a desire to learn ethical and compliant business practices.
Must be able to handle sensitive, stressful and confidential situations and account information.
Must have excellent keyboarding and 10-key skill-set.
Must have knowledge to perform functions requiring the use of the internet.
Our Mission: WHY WE EXIST. To extend the healing ministry of Jesus Christ. Our Core Values: WHAT WE BELIEVE IN.DIGNITY Respect for the worth of every person, recognition and commitment to the value of diverse individuals and perspectives, and special concern for the poor and underserved. INTEGRITY Honesty, justice, and consistency in all relationships. EXCELLENCE High standards of service and performance. COMPASSION Service in a spirit of empathy, love, and concern. STEWARDSHIP Wise and just use of talents and resources in a collaborative manner.Our Vision: WHAT WE ARE STRIVING TO DO. CHRISTUS HEALTH, a Catholic health ministry, will be a leader, a partner and an advocate in the creation of innovative health and wellness solutions that improve the lives of individuals and communities so that all may experience God's healing presence and love. Our Name and Symbol:WHO WE ARE. CHRISTUS is Latin for "Christ," and proclaims publicly the core of our mission. OUR NAME choice also recognizes the heritage of our two congregational sponsors, the Sisters of Charity of the Incarnate Word in Houston and San Antonio. Jesus Christ is the Incarnate Word, the Word of God made flesh. It is, theref...ore, only fitting that it is in another form of His name that our health ministries are called together. OUR SYMBOL Reflects the healing ministry of Jesus Christ - a combination of a medical cross and a religious cross. The flowing banner on the cross is a common symbol of the risen Christ, while the royal purple signifies Christ. The flowing banner also conveys a sense of motion as we move forward into a new era of service to our communities.